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Lessons Learned
Jessica Neuwirth Retail Marijuana Education & Youth Prevention Coordinator, Prevention Services Division
Marijuana Education & Prevention in Colorado
Enact the will of the people while preserving
public health
Educate for safe, legal and responsible use
CDPHE ON RETAIL
MARIJUANA
1. Medical Marijuana Registry
2. Marijuana Health Monitoring and Research
3. Retail Marijuana Education and Youth Prevention
4. Laboratory: MJ Lab Inspections, MJ Ref Lab
5. Consultation: Edible Safety, Proper disposal of waste
ROLES OF CDPHE
LESSON #1 Improve data
and trend reporting
MJ USE DURING PREGNANCY- CO
5.7%
14% 13% 4% 3%
11% 10%
PRAMS, 2014
MJ USE DURING PREGNANCY- CO
13% 6% 6%
PRAMS, 2014
Drank Alcohol
Used Tobacco
Used Marijuana
MJ USE DURING PREGNANCY- CO
11% 6% 5%
3 MONTHS BEFORE DURING POST-
PARTUM
PRAMS, 2014
ANY SMOKING DURING PREGNANCY- CA
11% 3% 6%
3 MONTHS BEFORE DURING POST-
PARTUM
MIHA, 2013-2014
LESSON #2 What will you
say?
Reports & Factsheets:
• CA Department of Public Health
• CO Department of Public Health
• National Academies of Science
BIOLOGICAL EVIDENCE
There is no known safe amount of marijuana use during pregnancy.
THC can pass from mother to the unborn child through the placenta.
BIOLOGICAL EVIDENCE
The unborn child is exposed to THC used by the mother during pregnancy.
THC can be passed from the mother’s breast milk, potentially affecting the baby.
EFFECTS ON EXPOSED
OFFSPRING
Maternal use of marijuana during pregnancy is associated with decreased cognitive function and attention. These effects may not appear until adolescence.
Maternal use of marijuana during pregnancy is associated with decreased growth during childhood.
EFFECTS ON BIRTH
OUTCOME
LIMITED • Heart defects • Low birth weight • Birth defects • Gastroschisis
MIXED • Neural Tube Defects • Preterm delivery • Decreased birth weight • Small for gestational age • Still birth
BREASTFEEDING
INSUFFICIENT
Breastfeeding and SUIDS
MIXED
Breastfeeding and infant motor
development
RESEARCH GAPS
• Cannabidiol (CBD) and other cannabinoids
• Other methods of use besides smoking
• Miscarriage
• Potency
• Breastfeeding
- Effects on infants
- Length of time THC remains in breast milk
- Studies to correlate urine THC levels with
presence of THC in breast milk
LESSON #3 Get
information out quickly
INFLUENCERS
WHAT WOMEN WANT TO
KNOW
Effects on fetus development and growth.
Long-term health effects for their babies
How THC is passed/stored in their baby’s body.
Recommendations
Screen at every visit
Encourage cessation & talk about risks of use
Discuss plans for breastfeeding
MOTIVATIONAL INTERVIEWING
Can you tell me about why you are using marijuana? How does it help you? Do you want to stop using marijuana? How difficult do you think it will be to stop using marijuana? Do you think you can stop?
Talking to patients about medical marijuana
Determining if the benefits outweigh
the potential risks
Marijuana Pregnancy and
Breastfeeding Guidance For
Colorado Health Care Providers
Pediatric Exposure Prevention Clinical
Guidance For Discussions with
Children & Adolescents Ages 9-20
Pediatric Exposure Prevention Clinical
Guidance For Discussions with
Parents or Guardians
Webinar Available
Available through
www.CO.Train.org
TESTING
When? Who?
What happens next?
Mandatory Reporting
Some hospitals test babies after birth for drugs.
If a baby tests positive for THC at birth, Colorado law says
child protective services must be notified.
If you as a health care provider have a suspicion of abuse or neglect, it is your duty as a mandatory reporter to report child abuse or neglect.
FINAL LESSONS
Listen to your audience
Adapt local health policy
Respect personal ideology, but know you will upset both sides
RESOURCES AND SOURCES
Good to Know Colorado social marketing campaign GoodToKnowColorado.com
Free resources for order
http://cohealthresources.org/
Colorado Clinical Guidelines https://www.colorado.gov/pacific/sites/default/files/MJ_RMEP_Factsheet-Pregnancy-Breastfeeding.pdfects-while-pregnant-or-breastfeeding
Monitoring Marijuana in Colorado Report
https://www.colorado.gov/pacific/marijuana/effects-while-pregnant-or-breastfeeding
Therese McCluskey, Alameda County
Emily Adams, Humboldt
